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Baerveldt glaucoma implant in paediatric patients

The Rotterdam Eye Hospital, Rotterdam, Netherlands

Correspondence to:
Correspondence to:
P W T de Waard
The Rotterdam Eye Hospital, Schiedamse Vest 180, 3011 BH Rotterdam, Netherlands; pwt.de.waard{at}xs4all.nl

Aim: To evaluate the Baerveldt glaucoma implant (BGI) in paediatric glaucoma treatment.

Methods: In a retrospective non-comparative case series 55 eyes of 40 consecutive paediatric patients (16 years) with primary or secondary glaucoma underwent Baerveldt (350 mm²) implantation. Surgical outcome was evaluated by Kaplan-Meier table analysis.

Results: The overall success rate was 80% at last follow up, with a mean follow up of 32 (range 2–78) months. Cumulative success was 94% at 12 months and 24 months, 85% at 36 months, 78% at 48 months, and 44% at 60 months. 11 eyes (20%) failed postoperatively because of an IOP >21 mm Hg (eight eyes), persistent hypotony (two eyes), and choroidal haemorrhage following cataract surgery (one eye). The most frequent complication needing surgery was tube related (20%). A new observation was mild to moderate dyscoria in 22% of the eyes, all buphthalmic, caused by entrapment of a tuft of peripheral iris in the tube track.

Conclusions: The BGI is effective and safe in the management of primary and secondary glaucoma. When angle surgery has proved to be unsuccessful or inappropriate in paediatric patients, a BGI is a good treatment option. One must be prepared to deal with the tube related problems.

Keywords: glaucoma; Baerveldt implant; congenital glaucoma; paediatrics